crossing96/oncoscreening huggingface dataset:
Neurovascular preservation in orthotopic cystectomy: impact on female sexual function.	OBJECTIVES: The published data regarding female orthotopic cystectomy have focused primarily on urethral recurrence and urinary continence. In a new era of sexuality, evaluating postoperative sexual outcome has become a new surgical endpoint. In this study, we focused on the impact of neurovascular preservation after radical cystectomy and neobladder construction. METHODS: We assessed female sexuality in 13 patients after orthotopic cystectomy using a standardized questionnaire, Female Sexual Function Index (FSFI). Six patients had undergone nerve-sparing cystectomy and seven had undergone contemporary non-nerve-sparing cystectomy. Intraoperatively, the tumor was deemed oncologically safe for neurovascular preservation. All 13 patients were sexually active preoperatively, were younger than 65 years old, had recurrence-free follow-up findings after 1 year, and had undergone no pelvic irradiation. The 19-item FSFI questionnaire analyzed six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) of sexual function. RESULTS: In the nerve-sparing group (mean age 55.9 years), the baseline and 12-month postoperative scores showed a minimal decline in results, with a total mean FSFI score of 24.5 versus 22.3, respectively. In analyzing each of the six domains, no significant decline or difference was observed. Conversely, in the non-nerve-sparing group (mean age 56.7 years), a significant decline or difference was found in the 12-month total mean FSFI scores between the baseline and postoperative FSFI scores (25.0 versus 11.0, respectively). In the non-nerve-sparing group, 6 of 7 patients ultimately discontinued sexual intercourse. CONCLUSIONS: Female sexual function was preserved in patients who received neurovascular preservation. In contrast, all domains of sexual function declined in patients who had undergone non-neurovascular preservation.	bladder
Metallothionein-1 and -2 expression in cadmium- or arsenic-derived human malignant urothelial cells and tumor heterotransplants and as a prognostic indicator in human bladder cancer.	The goal of this study was to determine if the expression of the metallothionein (MT)-1/2 proteins might serve as a biomarker for the development of bladder cancer. A retrospective analysis of MT-1/2 staining was performed on 343 tissue sections from patients referred for the diagnosis of bladder cancer. The specimens were subdivided into six categories: benign, dysplastic, low-grade cancer, high-grade cancer with no evidence of invasion, high-grade cancer with evidence of invasion, and carcinoma in situ. There was no expression of MT-1/2 in benign lesions and low-grade cancers, a low incidence of expression in dysplastic lesions and high-grade cancers with no evidence of muscle invasion, and a significantly increased incidence of MT-1/2 in high-grade cancers that had invaded the underlying matrix. The expression of MT-1/2 varied in intensity from sample to sample and was focal in its expression. It was concluded from these findings that MT-1/2 may be a prognostic marker for cancers that are progressing to invade the underlying stroma of the bladder wall. The expression of MT-1/2 was also determined in a cell culture model of human urothelium that had been malignantly transformed by Cd2+ and As3+ and shown to be capable of tumor formation in nude mice. It was demonstrated that the expression of MT-1/2 in the tumor heterotransplants was similar to the pattern found in archival specimens of high-grade bladder cancers. The MT-1/2 staining in the heterotransplants was focal in pattern, varied in intensity, and highest in the less differentiated cells of the tumor. These findings indicate that the cell culture model may serve to help define the role of MT-1/2 expression in bladder cancer invasion.	bladder
Role of gemcitabine in cancer therapy.	Gemcitabine, a pyrimidine nucleoside antimetabolite, is one of the most promising new cytotoxic agents. The drug has shown activity in a variety of solid tumors, and has been approved for the treatment of non-small cell lung cancer, pancreatic, bladder, and breast cancer. Recent data showed that gemcitabine is also active against ovarian cancer. Gemcitabine has a good toxicity profile, with myelosuppression being the most common side effect, while non-hematological events are relatively uncommon. The low toxicity profile makes the drug a valid option for unfit and elderly patients. Due to the synergistic activity with other chemotherapeutic compounds, mainly cisplatinum, several trials have been conducted to evaluate the efficacy and tolerability of gemcitabine in combination with other cytotoxic agents. Current clinical trials are evaluating the role of gemcitabine in combination with new targeted therapies.	bladder
Fluorescence in-situ hybridisation on biopsies from clam ileocystoplasties and on a clam cancer.	The incidence of carcinoma following an enterocystoplasty increases with time and is a major concern after such procedures. The aim of this study was to investigate genetic instability (in the form of numerical chromosomal aberrations) at the enterovesical anastomosis in patients who had undergone a clam ileocystoplasty using fluorescent in-situ hybridisation (FISH). Fluorescent in-situ hybridisation was performed on touch preparation samples prepared from fresh endoscopic biopsies obtained from the enterovesical anastomosis and native bladder remnant (control specimens) of 15 patients who had undergone a clam ileocystoplasty. Fluorescent in-situ hybridisation was also performed on one squamous cell cancer specimen. Significant aneusomic changes were found at the enterovesical anastomosis in all 15 patients. Alterations in chromosome 18 copy number were the most frequent abnormal finding (trisomy 18, n=8; monosomy 18, n=7). Nine patients were monosomic for chromosome 9. Isolated monosomy 8 and trisomy 8 were each found in one patient. The control specimens were all normal. An unusually high incidence of polysomic cells was found in the clam tumour specimen, reflecting the aggressive nature of this cancer. Chromosomal numerical abnormalities occur at the enterovesical anastomosis following a clam ileocystoplasty and chromosome 18 appears to be a particularly good marker of genetic instability. The results of this study indicate that morphologically normal tissue obtained from the enterovesical anastomosis displays evidence of chromosomal instability that may predispose to tumour formation. However, further prospective, blinded, longitudinal studies are required to establish whether predetermined FISH signal patterns in enterocystoplasty cells in urine or obtained by biopsy predict the presence or absence of tumour.	bladder
From the Archives of the AFIP: neoplasms of the urinary bladder: radiologic-pathologic correlation.	In the United States, primary bladder neoplasms account for 2%-6% of all tumors, with bladder cancer ranked as the fourth most common malignancy. Ninety-five percent of bladder neoplasms arise from the epithelium; the most common subtype is urothelial carcinoma, which accounts for 90% of cases. Squamous cell carcinoma accounts for 2%-15%, with rates varying widely according to geographic location. Adenocarcinoma (primary bladder, urachal, or metastatic) represents less than 2%. Bladder cancer typically occurs in men aged 50-70 years and is related to smoking or occupational exposure to carcinogens. Most urothelial neoplasms are low-grade papillary tumors, which tend to be multifocal and recur but have a relatively good prognosis. High-grade invasive tumors are less common and have a much poorer prognosis. Squamous cell carcinoma and adenocarcinoma occur in the setting of chronic bladder infection and irritation. Mesenchymal tumors represent the remaining 5% of bladder tumors, with the most common types being rhabdomyosarcoma, typically seen in children, and leiomyosarcoma, a disease of adults. Rarer mesenchymal tumors include paraganglioma, lymphoma, leiomyoma, and solitary fibrous tumor. Although imaging findings are not specific for these tumors, patterns of growth and tumor characteristics may allow differentiation. For accurate staging, computed tomography and magnetic resonance imaging are the modalities of choice.	bladder
A non-invasive QPCR method monitoring DNA based therapy of bladder cancer patients.	Real-time PCR technology is highly advantageous for gene studies based on the genetic nature of the transferred material. Urine and blood samples were collected before and after treatment. Treatment of bladder carcinoma patients with plasmid constructs expressing the diphtheria toxin gene was monitored. Detection range from 5x10(6) copies to <or=10 copies was observed with repeatability and reproducibility. No trace amount of the plasmid was detected in the patient's bloodstream, and a continuous clearance in urine, as well, was observed 72 h post-injection. These results show the possibility to design a follow-up method to monitor quantitatively the amount of the plasmid DNA in bladder cancer patients.	bladder
Functional polymorphisms in the promoter regions of the FAS and FAS ligand genes and risk of bladder cancer in south China: a case-control analysis.	BACKGROUND: FAS and FASLG together initiate apoptosis, which prevents tumor development. FAS and FASLG polymorphisms in the promoter regions can alter the transcriptional activities and thus alter risk of cancer. We hypothesized that the FAS -1377G>A, -670A>G, and FASLG -844T>C polymorphisms are associated with risk of bladder cancer. METHODS: In a hospital-based case-control study of 216 case patients with newly diagnosed bladder transitional cell carcinoma and 252 cancer-free controls frequency-matched by age and sex, we genotyped polymorphisms using PCR-restriction fragment length polymorphism. RESULTS: We found a statistically significantly increased risk of bladder cancer associated with the FASLG -844CC genotype [adjusted OR=1.51; 95% CI 1.03-2.23] compared with -844 (CT+TT). Consistently, the FAS haplotype genotypes with 2-4 variant (risk) alleles (-1377A and -670A) were associated with an increased risk of bladder cancer compared to 0-1 variants (OR=2.14; 95% CI 1.10-4.16). Furthermore, when we evaluated these three polymorphisms together, we found that the combined genotypes with 4-6 variant (risk) alleles (-1377A, -670A, and -844C) were associated with an increased risk of bladder cancer (OR=1.58; 95% CI 1.07-2.34) compared to 1-3 variants, and this increased risk was more pronounced among subgroups of aged >50 years (OR=1.70; 95% CI 1.11-2.61) and smokers (OR=1.88; 95% CI 1.06-3.32). CONCLUSIONS: FAS and FASLG polymorphisms appear to jointly contribute to risk of bladder cancer in this southern Chinese population. Larger studies are needed to verify these findings.	bladder
Leanness, smoking, and enhanced oxidative DNA damage.	An increased risk of some forms of cancer, including lung cancer, among lean individuals has been consistent; however, there is a paucity of biological evidence supporting this relation. Subjects analyzed were 177 healthy Japanese workers who participated in a lifestyle intervention study. The levels of urinary 8-hydroxydeoxyguanosine (8-OHdG), a marker of oxidative DNA damage, were measured using an automated high-pressure liquid chromatography and urinary creatinine levels were adjusted for before statistical analysis. A clear inverse association was found between body mass index (BMI) and 8-OHdG levels among smokers [Pearson correlation coefficient (r) = -0.48], and the association did not materially change after adjustment for potential confounding factors. In contrast, no apparent relation was observed between BMI and 8-OHdG levels among nonsmokers (r = -0.12), although lean nonsmokers had a slightly higher mean of 8-OHdG levels compared with nonlean nonsmokers. The interaction of smoking and BMI reached statistical significance (P = 0.04). Leanness may enhance oxidative DNA damage induced by smoking and thus serve as a marker of host susceptibility to smoking-related cancers.	bladder
Chemo-prevention in superficial bladder cancer using mitomycin C: a survey of the practice patterns of British urologists.	OBJECTIVE: To assess the use of mitomycin C, by urologists within the UK, as a single-dose intravesical agent. Current European recommendations are to use one dose after any new tumour resection. METHODS: We assessed the current patterns of mitomycin C usage amongst British urologists, particularly with reference to one instillation after resecting a new bladder tumour, hypothesizing that British urologists would use mitomycin C in line with current guidelines. A one-page questionnaire was mailed to 527 consultant urologists in the UK enquiring about their use of mitomycin C in superficial bladder cancer. A second mailing was sent to encourage nonresponders. RESULTS: Of the 527 consultants, 320 (61%) replied, of which 313 (59%) questionnaires were evaluable. Of these 313 respondents, 299 (95%) used mitomycin C; 244 respondents (82%) advocated the use of one dose of mitomycin C after resecting a new tumour, but only 10 (4%) would use it immediately after tumour resection and 155 (64%) use it within 24 h. Most (98%) respondents favoured the use of a mitomycin C course after resecting multiple tumours or after multiple recurrences. Interestingly, 20 respondents (7%) would use mitomycin C as a first-line therapy for carcinoma in situ and a further 23 (8%) would use it for G3T1 tumours. A minority (14%) would use it after nephrectomy for upper tract transitional cell carcinoma. Almost all respondents indicated a dose of 40 mg in 40 mL of diluent. Maintenance treatment with mitomycin C was advocated by 44 (15%) of respondents, mainly for recurrent multifocal Ta/T1 tumours. The perception of the side-effects of mitomycin C was favourable, with 69% of respondents judging mitomycin C to be well tolerated with mild side-effects. CONCLUSION: Urologists adopt new ideas rapidly, as shown by the wide acceptance of the UK Medical Research Council study. The prompt use of mitomycin C needs to be reinforced, as efficacy is optimum within 6 h of resection. A few consultants persist in continuing with established practices, which have little evidence base. The publication of such survey results, with guidelines for treatment, should encourage those urologists whose practice is at variance from the norm to reflect on and change their practice.	bladder
[Metastatic tumors of the hand in three cases].	Metastatic malignancies of the hand are rare and they usually develop from lung, breast, and kidney tumors. Metastases to the bones of the hand can cause pain, swelling, soft tissue ulceration, and osteolytic destruction. We presented three patients with metastatic tumors of the hand, whose ages were 58 (male), 42 (female), and 40 (male) years. Metastases developed in the thumb and the big toe, metacarpal bone, and the nail bed following treatment for primary tumors of the bladder, colon, and chondrosarcoma of the proximal femur, respectively. One patient underwent amputation of the thumb and the big toe followed by systemic chemotherapy, one patient with metacarpal involvement was treated with Ray amputation, and the latter underwent a biopsy. Histopathological diagnoses were consistent with primary tumors.	bladder
The pathology of bladder cancer.	"Pathologists play an important role in the management of urinary bladder cancer by making a careful morphologic assessment of the primary tumor and its relation to adjacent structures. Ideally, evaluation of the primary site will segregate patients into groups with distinct clinical features, biologic behavior, and response to therapy. Traditionally, to accomplish this goal, pathologists have relied on factors such as histologic tumor type, grade, depth of invasion, and presence or absence of vascular invasion. Recently, in an effort to enhance our ability to subclassify these patients, we have introduced new modalities, such as flow cytometry, monoclonal antibodies, assessment of proliferative rate, and cytogenetics and molecular genetics. Without question we are advancing into an era in which tumors will be classified based on their molecular ""fingerprint."" Nevertheless, at this time, morphology remains the ""gold standard"" and, consequently, the best tool to assess the biologic potential of early bladder cancer. Despite this undeniable fact, there are many problems with the pathologic evaluation of these tumors, mostly because of the inherent subjectivity of the field and the lack of universal, standardized criteria for the evaluation of the above-mentioned morphologic parameters. Publications in peer-reviewed journals and the proliferation of educational opportunities by way of seminars, conferences, and web-based tutorials play an important role in keeping the practicing pathologist informed and up to date. As novel concepts and modern techniques are reported, their clinical value must be validated prospectively. Expert pathology review and establishment of exportable practice standards play an important role in the process."	bladder
Comparative study of intelligent models for the prediction of bladder cancer progression.	New techniques for the prediction of tumour behaviour are needed since statistical analysis has low accuracy and is not applicable to the individual. Artificial intelligence (AI) may provide suitable methods. We have compared the predictive accuracies of neuro-fuzzy modelling (NFM), artificial neural networks (ANN) and traditional statistical methods for the prediction of bladder cancer. Experimental molecular biomarkers, including p53 expression and gene methylation, and conventional clinicopathological data were studied in a cohort of 117 patients with bladder cancer. For all 3 methods, models were produced to predict the presence and timing of tumour progression. Both methods of AI predicted progression with an accuracy ranging from 88-100%, which was superior to logistic regression, and NFM appeared to be better than ANN at predicting the timing of progression.	bladder
Comparison of NMP22 BladderChek test and urine cytology for the detection of recurrent bladder cancer.	OBJECTIVE: To assess the clinical performance of the NMP22 BladderChek test, which is a qualitative test, and to compare it with voided urine cytology for the detection of recurrent bladder cancer. We also evaluated whether cystoscopy can be omitted from the surveillance protocol by combining the two tests. METHODS: A total of 131 patients with a history of superficial transitional cell carcinoma of the bladder provided urine samples before a cystoscopic examination. Urine samples were assayed for the presence of NMP22 using the NMP22 BladderChek test and cytology was performed by a cytopathologist. Selected patients underwent a biopsy, with appropriate additional therapy. Results of the two tests were compared with that the results of cystoscopy, which was retained as the gold standard. For positive biopsies, the results of the NMP22 test and cytology were also correlated with the tumor stage and grade. RESULTS: Of the 46 recurrences detected by cystoscopy, the NMP22 test was positive in 39 cases and cytology in 19 cases. The sensitivity of the NMP22 test was 85%, which was significantly greater than that of cytology (41%). In particular, for low-risk tumors it was eight times more sensitive than cytology. The specificities of the NMP22 test and cytology were 77 and 96%, respectively. Combining the two tests increased overall sensitivity to 91%. However, 9% of the tumors were still not detected. CONCLUSION: The NMP22 BladderChek test is an in vitro qualitative test that is easily available and cheap; it can be performed by a urologist in the office and results can be interpreted within 30 min. The NMP22 test is superior to cytology for all grades and stages in the detection of recurrence in patients with a history of superficial bladder cancer. Our study indicates that the NMP22 test can be used as a substitute for urine cytology. The NMP22 test cannot replace cystoscopy, but it can be used as an adjunct to cystoscopy in the surveillance protocol for patients with superficial bladder cancer.	bladder
Radical cystectomy for invasive bladder cancer: long-term results of a standard procedure.	Radical cystectomy with an appropriate lymphadenectomy remains the standard of therapy for high-grade invasive bladder cancer. This surgical approach provides the best survival rates with the lowest local recurrence rates and orthotopic diversion can be performed safely in most patients with an acceptable outcome and quality of life. Pathologic analysis of the bladder tumor and regional lymph nodes will help direct the need for adjuvant therapy in high-risk individuals. Equivalent long-term local control and survival are not seen with other forms of treatment including radiation therapy, chemotherapy, or a combination of the two. The rationale and clinical results of large, contemporary cystectomy series are presented, which provide a benchmark of outcomes with this form of surgical treatment.	bladder
Raf1, Aurora-A/STK15 and E-cadherin biomarkers expression in patients with pTa/pT1 urothelial bladder carcinoma; a retrospective TMA study of 246 patients with long-term follow-up.	AIMS: The study was designed to evaluate Raf1, Aurora-A/STK15 and E-cadherin (E-CD) protein expression and their prognostic value in patients with pTa/pT1 tumours. MATERIALS AND METHODS: A tissue microarray of 105 pTa, and 141 pT1 tumours was constructed and sections were immunostained with these three antibodies. RESULTS: There were significant associations between Raf1 overexpression and tumour grade (p = 0.03), between Aurora-A overexpression/alterations of E-CD and tumour grade and stage (p < 0.001 and p < 0.001). In multiple Cox regression analysis, moderate/strong expression of E-CD seemed to be an independent factor in predicting slower tumour progression (p = 0.003) and Aurora-A overexpression (p = 0.022) displays an independent value in predicting tumour recurrences. CONCLUSION: Evaluation of E-CD and Aurora-A expressions in tissue of patients with pTa/pT1 UC have been proven to be useful in predicting tumours behavior and Raf1 protein expression seemed to have no potential use in this regard.	bladder
Is a second transurethral resection necessary for newly diagnosed pT1 bladder cancer?	PURPOSE: We evaluated the potential benefit of a second transurethral resection in patients with newly diagnosed pT1 transitional cell carcinoma of the bladder. MATERIALS AND METHODS: Between January 2001 and May 2003, 80 patients with stage T1 bladder cancer were included in this protocol in which all patients prospectively received second TUR within 2 to 6 weeks following the initial resection. Patients with incomplete resections were excluded from study. The pathological findings of the second TUR were reviewed. RESULTS: Of the 80 patients who underwent second resection, 18 (22.5%) had macroscopic tumors before resection. However, with the addition of microscopic tumors, overall residual disease was determined in 27 (33.8%) patients. Of the 27 patients 7 had pTa, 14 had pT1, 3 had pT1+pTis and 3 had pT2 disease. Residual cancers were detected in 5.8%, 38.2% and 62.5% in G1, G2 and G3 tumors, respectively. The risk of residual tumor directly correlated with the grade of the initial tumor (p = 0.009). CONCLUSIONS: Although second TUR dramatically changed the treatment strategy in a small percentage of cases, we strongly recommend performing second TUR in all cases of primary pT1 disease, especially in high grade cases.	bladder